AB0190 THE LONG-TERM PREDICTORS OF FATIGUE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS
Authors: D. Santos Oliveira, A. Martins, B. Samões, F. R. Martins, F. Oliveira Pinheiro, M. Rato, R. Nicolau, C. Vaz, M. Bernardes, L. Costa
Journal: Annals of the Rheumatic Diseases (2022)

Background Fatigue is one of the major complaints of patients with rheumatoid arthritis (RA). However, the literature relating fatigue to other disease-related parameters has presented discrepant results and longitudinal studies with multivariate analyses are scarce. Objectives To explore potential associations between fatigue and demographic variables and other patient-reported outcomes (PROMs) in patients with RA treated with biological disease-modifying antirheumatic drugs (bDMARDs) over the time. Methods A 24-month (24M) monocentric observational retrospective cohort study was conducted. Patients diagnosed with RA, according to the 2010 American College of Rheumatology (ACR)/ European League Against Rheumatism (EULAR) criteria, and registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) who started their first bDMARD between 2015 and 2021 were included. Age, gender, disease duration, body mass index (BMI) and PROMs were obtained by consulting Reuma.pt. Fatigue was monitored at baseline, 12 and 24M using Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), a 13-item questionnaire with a total score ranging from 0 to 52. A score ≤ 39 indicates the presence of clinically significant fatigue. Health Assessment Questionnaire (HAQ), EuroQol-5D (EQ-5D), 36-Item Short Form Survey (SF-36), patient global assessment visual analogue scale (VAS) and pain VAS were assessed at baseline, 12 and 24M. Multivariate linear regression models were conducted with FACIT-F as the dependent variable. Results A total of 40 patients (47.4±11.4 years; 90.2% female) with a BMI of 29.87±8.54 kg/m 2 and a mean disease duration of 10.4±5.6 years were included. A total of 47.5% of patients were treated with an anti-TNF. About 85% of patients had clinically significant fatigue at baseline (FACIT-F 26.9±11.8). At baseline, patient global assessment VAS (β=-0.4, 95%CI [- 0.68; -0.095]) and pain VAS (β=- 0.34, 95%CI [-0.6; -0.068]) predicted fatigue. SF-36 predicted fatigue at baseline (β=0.35, 95%CI [0.14;0.56]), 12M (β=0.23, 95%CI [0.084;0.37]) and 24M (β=0.26, 95%CI [0.13;0.39]). HAQ predicted fatigue at baseline (β=- 12.2, 95%CI [- 19.8; - 4.5]) and 24M (β=- 11.4, 95%CI [- 17.47; - 5.38]). EQ-5D (β=39.5, 95%CI [15.84; 63.22]) predicted fatigue at 24M. Conclusion Our results showed that pain levels and patient global assessment of disease activity predicted a higher level of fatigue at baseline. The decrease in physical function and a worse overall health status perceived by patient predicted higher fatigue over the time. Previous research has suggested that disease-related factors, such as inflammation, pain or decreased physical function are associated with greater fatigue in RA (1). These findings encourage the pre-treatment screening of fatigue in patients with RA in order to design individualized non-pharmacological approaches in addition to bDMARDs therapy. References [1]Katz P. Curr Rheumatol Rep. 2017;19(5):25. Disclosure of Interests None declared